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Author: Rishi Sharma

Catch Up Pediatric Patients: MMR Vaccine

Catch Up Pediatric Patients: MMR Vaccine

There is a measles cluster in Philadelphia that started with an infant and spread to unvaccinated individuals. It has resulted in now 7 confirmed cases of measles among Philadelphia residents and an index case in Delaware county.

To prevent further spread, review your pediatric patients’ records for MMR vaccine and recall any patients who are not up to date. Consider nurse-only visits to get patients in faster. 

Measles is highly infectious and can be especially dangerous to children under 5, pregnant people, and immunocompromised individuals. CDC recommends children get their first MMR dose at 12-15 months and the second dose at 4-6 years. 

You can order a free measles flyer below.

New Beyond Use Date (BUD) Labels to Order

New Beyond Use Date (BUD) Labels to Order

New Beyond Use Date (BUD) labels are available for order. BUD labels can support your practice in ensuring vaccine is not used past expiration. These labels replace previous BUD labels intended for use with COVID-19 vaccine, and can be used for any adult or pediatric vaccine. Below is a preview:

These BUD labels are available to order for free below. Also, view and print the instruction sheet below for support in correctly using these new labels. If you have any questions, contact

Vaccine Product Available Through VFC: Abrysvo

Vaccine Product Available Through VFC: Abrysvo

Abrysvo is a maternal RSV vaccine available through the Vaccines for Children (VFC) program. 

RSV is surging and the pediatric infant immunization Beyfortus supply is severely limited. Abrysvo will play an important role in protecting infants against severe RSV disease this season. Most infants born to mothers who have received Abrysvo will not need to receive Beyfortus. 

Please note that the availability of Abrysvo for VFC providers is limited. Only sites that care for pregnant people under 19 can order, and orders will be limited to 5 doses per site at a time.


Abrysvo is a Pfizer product now available through the Vaccines Children (VFC) program.

  • CVX code: 305
  • CPT code: 90678
  • NDC number: 00069-0344-01

V-safe, one of several systems CDC uses to closely monitor the safety of vaccines, will be used as a health check for pregnant people who receive a maternal RSV vaccine.

For more information, review the package insert.

Additional resources:

FDA page

If you have any questions, please email

Administration Errors: RSV for Infants

Administration Errors: RSV for Infants

On November 30, CDC alerted immunization programs that they have received reports of infants being mistakenly administered RSV vaccines intended for adults. Infants should only receive the RSV preventive antibody, nirsevimab (Beyfortus, Sanofi).

RSV vaccines (Arexvy by GSK and Abrysvo by Pfizer) are recommended only for adults and have not been evaluated for safety or effectiveness in infants or children. Practices that carry both adult RSV vaccine and pediatric RSV preventive antibody products should review their immunization administration safety procedures to ensure only the correct product is administered to recipients. This is an opportunity to re-educate and re-train staff on RSV immunization formulations and practices.

In the event that a vaccine administration involving RSV vaccine occurs, CDC encourages vaccinators to promptly report errors to the Vaccine Adverse Event Reporting System (VAERS). Also, inform parents of error so that these infants can receive the correct product and be monitored for adverse reactions. 

CDC Clinical Guidance (updated December 7, 2023)

Because there are no data on the efficacy/effectiveness of RSV vaccines in preventing RSV disease in this age group, the infant should receive nirsevimab if otherwise eligible based on maternal RSV vaccination status. There is no specific recommendation for a minimum interval between administration of incorrect RSV vaccine and nirsevimab. Some experts suggest:

• That it could be reasonable to consider waiting 48 to 72 hours before proceeding with nirsevimab administration. This time frame is when we would expect side effects to the RSV vaccine, such as fussiness, would be most likely.

• Consideration should be given to administering nirsevimab in the limb opposite to where the RSV vaccine was administered to avoid potential interaction or binding of RSV antibody and vaccine, thereby reducing the effectiveness of nirsevimab.

If further clinical guidance is needed, connect with our medical experts at or CDC experts at

Holiday Season Storage and Handling Reminder

Holiday Season Storage and Handling Reminder

Ensure your vaccines stay properly monitored over the holiday season!

The Digital Data Loggers (DDLs) provided by PDPH have limited storage space and stop recording temperatures when full. If you are using one of these DDLs, please download your DDL files before the holidays if your office will close or you have limited availability. This may mean downloading your DDLs earlier than usual to ensure they continue recording temperature readings for your storage units into the new year. 

If your office will be closed for an extended time, you can reach out to our team to discuss temporarily storing your vaccine at our office for safekeeping. 

As a reminder, when sending in your data, please always: 

1) Email both your LTD (yellow and blue) and CSV (green) files to

2) Upload your CSV files into the Clinic Tools module in PhilaVax 

If you need assistance or have additional questions, please get in touch with our Storage and Handling team at

Deauthorized COVID-19 Products

Deauthorized COVID-19 Products

As a reminder, only the approved 2023 – 2024 COVID-19 products listed below may be administered at this time:

Authorized 2023 – 2024 Products
Formulation: Monovalent XBB.1.5

  • Pfizer 12+: NDC 00069-2362-10
  • Pfizer 5-11: NDC 59267-4331-02
  • Pfizer 6mo-4yrs: NDC 59267-4315-02
  • Moderna 12+: NDC 8077-0102-95
  • Moderna 6mo-11yrs: NDC 8077-0287-92
  • Novavax 12+: NDC 80631-0105-02

Previously authorized monovalent and bivalent COVID-19 products have been deauthorized since September 12, 2023 and should have been removed from your inventory. If any patients were vaccinated with deauthorized products after September 12, they should be re-vaccinated with one of the 2023 – 2024 products. 

Here is a visual of all deauthorized products for your reference. For general questions on COVID-19 vaccine, email

Additionally, if you are interested in providing COVID-19 vaccine to underinsured and uninsured adults and have not yet enrolled in the Bridge Access Program, please reach out to Bridge Coordinator, to begin enrollment.

Mpox Vaccine Deliveries Paused for Thanksgiving

Mpox Vaccine Deliveries Paused for Thanksgiving

Mpox vaccine deliveries will be paused during the week of Thanksgiving, November 20-24, 2023.

Ordering will remain open this week until Wednesday, November 15 by 5:00 PM. The last delivery for mpox vaccine will be on Thursday, November 16. 

Remember to submit your temperatures to and complete a reconciliation of vaccine on hand for your order to be approved.

Click the button below to submit your order request for mpox vaccine.

Deliveries for mpox vaccine will resume on the week of November 27. If you have any questions, please contact Marguerite Horton at

Nirsevimab (Beyfortus) Updates

Nirsevimab (Beyfortus) Updates

Due to the unprecedented demand for nirsevimab, supply of this product is extremely limited through both the Vaccines for Children (VFC) program and the private market. Below is an update on available supply and tips on how to prioritize use of available doses. This a rapidly evolving situation. The information in this advisory reflects the most up-to-date information available to our program at this time. Updates released after this advisory will supersede this communication.

VFC Supply 

The CDC has set up an allocation system to distribute the supply of VFC doses still available from their distribution centers. At this time, no 100 mg doses have been allocated to Philadelphia. A limited number of 50 mg doses will be available later in November and December.  

The current VFC supply shipped and allotted to Philadelphia will not cover all eligible infants. Infants face the highest risk of RSV-related hospitalization in the first 5 months of life, especially in the first month.

To facilitate more equitable access to these products for eligible infants when they are most at risk, our program will implementing the following:

  • Redistribution of shipped doses. Given the supply of these products, our program will be redistributing doses that were shipped to sites last month in line with the current CDC recommendations. We will be reaching out to specific sites during the week of November 13, 2023 to coordinate picking up and delivering doses. We are basing the amounts moved on sites’ reported VFC-eligible population younger than 1 year of age, the amount of product received, and the subsequent usage.
  • Prioritization of birthing hospitals. To protect eligible infants when they are at highest risk for hospitalization, we will be prioritizing distribution of the 50 mg doses to birthing hospitals.

Private Supply

Per this press release from 11/6/23, Sanofi is contacting providers about distribution plans for doses available through the private market. New orders for the 100 mg dose are no longer being accepted, as the demand exceeded the available supply for the season. Distribution of the 50 mg doses in the private market is being managed to fulfill existing orders and provide equitable access to remaining doses. Please reach out to your Sanofi representative for more information.

Protecting infants from RSV this season

Given the limited availability of nirsevimab this season, consider these measures to protect infants:

  • Schedule outpatient appointments for unimmunized infants 0-2 months born during RSV season before they are > 5kg and no longer eligible for the 50 mg dose
  • Utilize Synagis for qualifying infants
  • Vaccinate eligible pregnant people with Abrysvo

Additional strategies are outlined in this CDC health advisory from 10/23/23.

Our program understands that this has been a challenging roll out. The Philadelphia VFC program was not aware of supply issues when fulfilling initial provider orders. We appreciate your understanding as our program works to more equitably distribute doses throughout the city as we navigate the national supply limitations. Sanofi and the CDC are working to address the issues that affected distribution this season to better prepare for the 2024 – 2025 season.